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PAPA GAZETTE |
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Editorial Advisory Board |
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Medicare will start covering medications for older patients from January 1, 2006 Business wise perhaps it opens up a new venue for pharmacists and provides an opportunity but at the same time it could be a liability due to its complicity and low reimbursement. Some of the PDP are asking for AWP -22% and above. Pharmacists must read the contracts carefully but should not let the low reimbursement discourage them from signing up for some Medicare plans because MTMP (Medication Therapy Program) may offset the cuts in reimbursement. Although it is not clear from the Medicare Prescription Drug Benefit Rules (42 CFR Part 400,403, 411, 417, and 423) how will the pharmacists will be reimbursed for this service, what standards will be adopted and what are the performance measures. I believe MTMP will become an important part of the Medicare Drug Benefit Program. Visit www.cms.hhs.com and www.ncpanet.org for more information. Help Patients Choose best Plans Pharmacists are in the best position to help beneficiaries choose Medicare Drug Plan and following is an update on marketing Do’s and Don’ts sent by Craig M Burridge of PSSNY |
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Medicare Rx Update 8/15/2005 Provider Marketing Guidelines are final… CMS has just issued its final Marketing Guidelines which contain important information for pharmacies and pharmacists planning to assist beneficiaries with the process of selecting a plan for the provision of their prescription drug benefits. As we have been assuring pharmacists, these guidelines encourage pharmacists to play an active role in assisting beneficiaries in an objective assessment of the beneficiary’s needs and potential plan options that may meet those needs (http://www.cms.hhs.gov/pdps/PrtDPlnMrktngGdlns.asp). Specific Guidance about Provider Promotional activities can be found at pp. 125-130 of the Guidelines. ... With “Do’s and Don’ts” for providers The final version of the Marketing Guidelines clarifies what a pharmacist may do in assisting a beneficiary in selecting a plan, but just as important, the guidelines also provide guidance to pharmacists on activities that are prohibited. Specifically Providers contracted with Plans (and their subcontractors) can: · Provide the names of plans with which they contract and/or participate · Provide information and assistance in applying for the limited income subsidy · Provide objective information on specific Plan formularies, based on a |
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